Objective To evaluate the outcome of surgical approaches in patients of gastric cancer with portal hypertension.Methods The clinical data of 80 patients with portal hypertension undergoing curative surgery for gastric cancer or simultaneous surgery for portal hypertension were retrospectively analyzed.Results The radical gastrectomy alone had no tremendous impact on postoperative liver function.But simultaneous surgery for portal hypertension affected patients' liver function dramatically (P =0.018).For those who underwent surgery for portal hypertension simultaneously,the incidence of complications in Child B patients was much higher than that in Child A patients (P =0.018).However,the incidence of complications did not differ between Child A and B patients who underwent radical gastrectomy alone.In addition,patients undergoing simultaneous surgery for portal hypertension had more severe complications than those who underwent radical gastrectomy only (P =0.042).Age ＞ 50 (P =0.012),tumor stage (P =0.015),and simultaneous surgery for portal hypertension (P =0.007) were the independent risk factors for postoperative liver dysfunction.The survival time of patients undergoing simultaneous surgery for portal hypertension was significantly shorter than that of patients undergoing radical gastrectomy only (in Child A patients,P =0.009,in Child B patients,P =0.000).Conclusions Individualized surgical approaches for the treatment of gastric cancer with portal hypertension should be decided by preoperative liver function.Simultaneous management of portal hypertension was not recommended.

Objective: To investigate the association between consumption of milk tea beverages and other sugary beverages with insomnia symptoms among college students, so as to the provide reference for promoting sleep quality among college students. Methods: From September to November 2023, a convenience sampling method was used to select 15 440 college students from seven universities in Shanghai, Jiangxi Province, Hubei Province, and Shanxi Province. A self developed questionnaire and the Insomnia Severity Index were used to assess milk tea beverage consumption, other sugary beverages and insomnia symptoms. Univariate analysis of insomnia symptoms among college students was performed using Chi square tests and Cochran-Armitage trend χ 2 tests. Multivariate Logistic regression analysis was conducted for the association between milk tea and other sugary beverage consumption with insomnia symptoms. Results: The detection rates of insomnia symptoms among college students was 40.83%. The frequency of consumption of different milk tea and various sugary drinks (juice, tea, milk, sodas,yogurt, functional drinks, coffee) per week was related to the detection trend rate of insomnia symptoms of college students ( χ 2 trend =38.38, 47.66, 74.16, 32.44, 65.78 , 38.71, 35.94, 91.59, P < 0.01 ). Multivariate analysis indicated that compared to individuals with no milk tea consumption, college students engaging in milk tea consumption had a significantly increased risk of insomnia symptoms ( OR =1.24, P <0.05). Students consuming milk tea at low to moderate frequencies (1-3, 4-5 times per week) showed a higher risk of insomnia symptoms compared to those with no consumption ( OR =1.20, 1.54, P <0.05). Furthermore, higher levels of milk tea consumption were significantly associated with insomnia symptoms (1 501-2 999 mL, OR =1.22; ≥3 000 mL, OR =1.36), and the consumption of other sugary beverages were also associated with insomnia symptoms of college students ( OR =1.10-1.55) ( P <0.05). Conclusions There is a relationship between consumption of milk tea beverage other sugary beverages with insomnia symptoms among college students. Colleges should regularly conduct dietary health education seminars to improve sleep quality among college students.

Objective:To explore the application effect of situation comedy teaching combined with peer teaching in clinical practice teaching of undergraduate nursing students.Methods:A total of 96 undergraduate nursing students who practiced in a first-class hospital at grade 3 in 2019 were randomly divided into the observation group and the control group, with 48 nursing students in each group. The control group adopted clinical teaching mode, including group theory teaching and group operation demonstration. On the basis of this, the observation group additionally adopted the clinical teaching mode of situation comedy teaching combined with peer teaching. The differences between the two groups in the assessment of nursing knowledge and skills assessment, independent learning ability and teaching satisfaction were observed. SPSS 20.0 software was used for t-test. Results:After the implementation of clinical teaching, the scores of nursing comprehensive ability of nursing students in the observation group (87.71 ± 5.11) were higher than those in the control group (78.47±6.24) ( P < 0.05). The independent learning ability of nursing students in the observation group (98.80±10.61) was significantly higher than that in the control group (74.47±9.83), and the difference was statistically significant ( P < 0.05). The score of teaching satisfaction in the observation group (2.83±7.07) was significantly higher than that in the control group (50.17±6.75), and the difference was statistically significant ( P < 0.05). Conclusion:The application of situation domedy teaching combined with peer teaching in the clinical teaching of undergraduate nursing students can improve their independent learning ability and clinical practice ability. Meanwhile, the process of teachers and students participating in situational experience and peer analysis and discussion can increase the teacher-student interaction, and improve the satisfaction of nursing students with clinical teaching.